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[预测食管癌新辅助放化疗反应的生物标志物]

[Biomarkers of predicting response to neoadjuvant chemoradiotherapy in esophageal cancer].

作者信息

Fu Jian-hua

机构信息

Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Sep;16(9):805-10.

Abstract

The prognosis of patients with locally advanced esophageal cancer treated by surgery alone is poor. The neoadjuvant chemoradiotherapy is considered to improve the long-term survival of patients with locally advanced esophageal cancer. The combination of neoadjuvant chemoradiotherapy and surgery has been recommended to be the standard treatment for the locally advanced esophageal cancer in China even in Europe and America countries. However, available evidence suggests that only those who had histopathologic response seemed to benefit the most from neoadjuvant chemotherapy while non-responders even had rather worse outcome compared to patients with surgery alone. Therefore, predictive markers of response to neoadjuvant chemoradiotherapy in locally advanced esophageal cancer are highly significant and needed. These markers would allow a tailored treatment to guide non-responders to alternative preoperative therapies and ultimately avoid ineffective, costly and seriously cytotoxic treatments. Results of most studies on biomarkers for predicting response to neoadjuvant chemoradiotherapy in esophageal cancer are promising. The potential utilization of biomarkers in clinical practice is urgently expected and needed, which plays an important role in guiding and improving the individualization of multimodality therapy in locally advanced esophageal cancer.

摘要

单纯手术治疗局部晚期食管癌患者的预后较差。新辅助放化疗被认为可提高局部晚期食管癌患者的长期生存率。在中国乃至欧美国家,新辅助放化疗联合手术已被推荐为局部晚期食管癌的标准治疗方法。然而,现有证据表明,只有那些有组织病理学反应的患者似乎从新辅助化疗中获益最大,而无反应者与单纯手术患者相比,结局甚至更差。因此,局部晚期食管癌新辅助放化疗反应的预测标志物具有高度重要性且十分必要。这些标志物将有助于进行个体化治疗,指导无反应者选择其他术前治疗方法,并最终避免无效、昂贵且具有严重细胞毒性的治疗。大多数关于食管癌新辅助放化疗反应预测生物标志物的研究结果很有前景。迫切期待并需要在临床实践中利用生物标志物,其在指导和改善局部晚期食管癌多模式治疗的个体化方面发挥着重要作用。

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